# Pilot Study of the Nutrition-Enhanced Wellness for Diabetes Self-Management Program (NEW-DSMP) among Low-Income Adults with Type II Diabetes

> **NIH NIH R21** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2021 · $199,397

## Abstract

ABSTRACT
Improving diabetes health is a public-health imperative. Type II diabetes mellitus (T2DM) is highly prevalent and
a leading cause of disability and cardiovascular disease in the US. T2DM disproportionately impacts low-income
individuals in the US, who are also at significant risk for food insecurity, defined as having limited access to
nutritious food for a healthy life. Food insecurity is associated with poor diabetes control, morbidity, and mortality.
Diabetes self-management education, such as that provided via the evidence-based Diabetes Self-Management
Program (DSMP), is an important aspect of diabetes care but does not address structural barriers to diabetes
health, such as lack of access to healthy foods to follow a diabetes diet. Medically-tailored, diabetes-healthy food
support may improve nutrition, self-management, mental health and diabetes health for low-income individuals
with T2DM based on preliminary studies. Yet the efficacy of this approach on diabetes health may vary
depending on the design of food support, how it is integrated with diabetes education, and how it is situated vis-
à-vis healthcare. Generating rigorous evidence to inform the design and implementation of medically-tailored
food interventions for diabetes is crucial, given the current policy interest in addressing the twin issues of food
insecurity and chronic illness via “food as medicine” approaches. Together with The Health Trust, a non-profit
organization with extensive experience providing the DSMP and nutrition services to low-income, chronically-ill
individuals in Northern California, we propose the Nutrition-Enhanced Wellness DSMP (NEW-DSMP) Pilot
Study. Our goal for this pragmatic, pilot cluster-randomized trial is to test the feasibility, acceptability and
preliminary impact of providing 12 weeks of diabetes-healthy food support (i.e. medically-tailored meals and
groceries), plus individualized sessions with a registered dietitian, to low-income individuals with T2DM
participating in the DSMP, compared to DSMP participation alone. Participants will be eligible if they have T2DM,
are over 21, are low-income, and speak English or Spanish. In Aim 1, we will conduct three focus groups to
investigate preferences, challenges, and opportunities for intervention design and implementation. In Aim 2, we
will pilot the NEW-DSMP intervention for feasibility, acceptability and preliminary impact using a cluster-
randomized design. We will randomize 6 DSMP groups (~12 people per group) 1:1 to intervention and control
arms (total individual n=72), following them over four assessments at 0, 6, 12 and 24 weeks with surveys,
anthropometry, and blood samples. Our primary outcome is glycemic control, measured via hemoglobin A1c;
secondary outcomes include fasting glucose and health-related quality-of-life. We will also test the impact on
intermediate nutritional, mental health, and behavioral outcomes. In Aim 3, we will conduct process evaluation
to understand inter...

## Key facts

- **NIH application ID:** 10102246
- **Project number:** 5R21DK123632-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Kartika Palar
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $199,397
- **Award type:** 5
- **Project period:** 2020-02-07 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10102246

## Citation

> US National Institutes of Health, RePORTER application 10102246, Pilot Study of the Nutrition-Enhanced Wellness for Diabetes Self-Management Program (NEW-DSMP) among Low-Income Adults with Type II Diabetes (5R21DK123632-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10102246. Licensed CC0.

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